BACKGROUND: Because B-type natriuretic peptide (BNP) secretion has a direct linear correlation with intravascular volume status, it was assessed as an initial marker for blood loss (BL) in polytrauma patients. METHODS: Hemodynamically unstable trauma patients between 18 and 45 years had serial BNP levels and hemoglobin (Hgb) levels obtained on admission, at 8 and 24 hours, and every morning during resuscitation. RESULTS: The 14 patients were categorized into 2 groups based on the 24-hour trend in Hgb levels: clinically significant blood loss (Hgb decrease >3 g/dL) or no clinical blood loss (Hgb decrease <3 g/dL). On admission, the 5 patients in the no blood loss group had normal BNP levels, whereas the 9 patients in the BL group had below-normal BNP levels. Because patients in the BL category were resuscitated, their BNP levels normalized. CONCLUSIONS: BNP levels below normal are indicative of intravascular volume loss in traumatically injured patients.
BACKGROUND: Because B-type natriuretic peptide (BNP) secretion has a direct linear correlation with intravascular volume status, it was assessed as an initial marker for blood loss (BL) in polytraumapatients. METHODS: Hemodynamically unstable traumapatients between 18 and 45 years had serial BNP levels and hemoglobin (Hgb) levels obtained on admission, at 8 and 24 hours, and every morning during resuscitation. RESULTS: The 14 patients were categorized into 2 groups based on the 24-hour trend in Hgb levels: clinically significant blood loss (Hgb decrease >3 g/dL) or no clinical blood loss (Hgb decrease <3 g/dL). On admission, the 5 patients in the no blood loss group had normal BNP levels, whereas the 9 patients in the BL group had below-normal BNP levels. Because patients in the BL category were resuscitated, their BNP levels normalized. CONCLUSIONS:BNP levels below normal are indicative of intravascular volume loss in traumatically injuredpatients.